HIV is increasing at high rates across sub-Saharan Africa (UNAIDS/WHO 2001). Current estimates are that 28.5 million adults and children are living with HIV/AIDS in sub-Saharan Africa (UNAIDS 2002a). Zimbabwe has one of the highest levels of HIV infection with an estimated 33.7% of adults 15 to 49 years old being HIV positive (UNAIDS 2002). The predominant mode of HIV transmission has been well documented in Zimbabwe and other parts of sub-Saharan Africa. While alcohol use appears to influence HIV risk behaviors, little is known about the causes and consequences of concurrent alcohol use and risky behavior for HIV/AIDS in sub-Saharan Africa. Even less is known about alcohol effects on HIV/AIDS disease progression in sub-Saharan Africa. The proposed study will address these research gaps by investigating how individual and environmental factors influence the concurrence of alcohol use and risky behavior, as well as HIV infection and disease progression, in rural Zimbabwe. The study will examine the process through which the risk of HIV infection is influenced over a two-year period by: typical alcohol use; behavioral beliefs, attitudes, social norms, protective factors and barriers, and intentions regarding the use of alcohol before risky behavior; concurrence of alcohol use and risky behavior; other individual factors; relationship characteristics; and, community conditions in rural Zimbabwe. The study also will evaluate the impact of a public opinion leader community-level intervention model on typical alcohol use, behavioral beliefs, social norms, and protective factors and barriers to concurrence of alcohol and risky behavior, and the risk of HIV infection over a two-year period. Finally, the study will investigate how HIV/AIDS disease progression is affected by typical alcohol use, co-morbidities (HBV, HCV), other individual factors, family support, health care use, and community characteristics over a two-year period. The proposed project will capitalize on an opportunity created by the ongoing ZiCHIRe study to collect additional survey and biological data at three time points over a two-year period from approximately 5,440 individuals (18 to 30 years old) across 32 villages in rural Zimbabwe. The proposed study will provide a better understanding of how alcohol use influences the risk of HIV infection and HIV/AIDS disease progression in resource-poor countries that can be used to develop more effective policies to reduce the spread and impact of HIV/AIDS in sub-Saharan Africa.